Tags: research

Acupuncture not working for you? It could be your coffee habit.

Even though acupuncture usually works well for you – do you sometimes find that a treatment may not give you the pain relief you were hoping for?  There are lots of possible reasons why, but your caffeine intake could be part of it.

coffee

In this study Caffeine inhibits analgesic effect of acupuncture – from The Journal of Chinese Medicine, the researchers found that both acute and chronic caffeine administration could reverse acupuncture’s pain relieving effect.  In the animal model studied, a dose of caffeine immediately preceding acupuncture as well as a daily intake  of 70mg/kg/day (average daily dose in Western countries) for 8 days, both negated the acupuncture -induced analgesia.

What does this mean for you? While this was an animal study, it does raise the question of caffeine consumption and beneficial outcomes in clinical practice.

Coffee (and caffeine in general) consumption can be a touchy subject in clinic.  I often work with patients in pain or dealing with insomnia, anxiety or digestive complaints.  Caffeine can negatively affect every one of those conditions – so reducing or eliminating coffee often becomes a topic of conversation.  A difficult topic – people are really attached to their coffee.  Don’t get me wrong.  I happen to love coffee. I’m not here to demonize it (or worship it for that matter).  But, I also find it enlightening to take a little break from it every now and then and watch what changes.

From observation of patients who come having just consumed coffee, I find they generally have a less pleasant experience – they are usually a little jumpier, more sensitive to the needles and aren’t able to relax quite as well.  This isn’t surprising if you are at all familiar with the sensations that result after drinking a strong coffee, and it makes sense considering the properties of coffee from a TCM perspective.

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The Institute for Traditional Medicine has an excellent article about the history and use of coffee in China and has this to say about coffee’s medicinal properties from a Traditional Chinese Medicine (TCM) paradigm:

“In sum, coffee dredges the liver to regulate the flow of liver qi, purges the gallbladder, opens the heart orifices, warms the blood circulation, detoxifies, and gently tonifies. However, while coffee dredges the liver qi, it does not necessarily smooth or soothe the liver qi. Therefore, one has to be cautious about the amount consumed and certain individuals will find the otherwise desirable effects distressing: releasing stagnated qi but not regulating its flow. As with other Chinese herbs, coffee would best be used in combination with herbs to moderate and enhance its effects. As an example, peony root (baishao) is often used to “soften” the liver, and smooth the flow of qi. Because coffee is consumed as a flavorful beverage, to pursue such an approach would best be done by having additional herbs taken in a form that wouldn’t alter the taste of the coffee, such as in pills. Excessive amounts of coffee will agitate the liver yang and even stimulate internal wind. Prolonged use of excessive amounts could thereby damage the blood, but for moderate amounts it serves as a valuable therapy for stagnated liver qi, with constricted circulation of blood, and constrained gallbladder function, with constricted elimination of damp and heat.” 
-COFFEE IN CHINA and the Analysis of Coffee According to Traditional Chinese Medicine, by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine

I’m not asking you to give up coffee forever but if you either consume caffeine on a regular basis and/or prior to treatment you may well be setting yourself up for less relief.   If you’re in pain and not getting the results you’d been hoping for, it may be worth laying off the coffee for a bit and giving acupuncture another try!

Have you taken some time off from coffee – have you noticed any changes in your health for better or worse? Share your experience in the comments!

 

Acupuncture Effective for Post-Surgical pain

While I love it when I can help patients avoid surgery (really, it happens all the time, and it’s awesome!) sometimes they can’t. Surgery is sometimes very necessary and when that’s the case, I support patients with acupuncture, bodywork, internal and external herbs so they can enter and recover from surgery as smoothly as possible.

Acupuncture and Chinese Medicine can be extremely useful tools both pre and post surgery.  Beforehand we can ready the body by helping manage pain, promote normal sleep and digestive cycles and prepare the tissue for the upcoming surgery.  After surgery we can work to reduce swelling and pain and often decrease or discontinue pain medications that have unwanted side-effects – all of this helps the surgical trauma heal quickly and appropriately.

A recent study in Regional Analgesia and Pain Medicine found that acupuncture after a total knee replacement reduced the amount of pain patients were in as well as reducing the need for and amount of pain medications required.  Those in the acupuncture group also had fewer adverse reactions (nausea and vomiting) due to anesthesia.
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acupuncture for post-op TKRResults: This study comprised 60 patients (30 in the study group and 30 in the control group). The fentanyl requirement via patient-controlled analgesia in the study group was lower [mean (SD), 620.7 (258.2) vs 868.6 (319.3) [mu]g; P = 0.002). The time to first request for fentanyl was longer in the study group. Pain intensity on a 100-mm visual analog scale was lower in the study group in the first 24 hours after the operation. The incidence of analgesia-related adverse effects of nausea and vomiting was lower in the study group. The success of blinding was not significantly different between the 2 groups (P = 0.731).

Conclusions: The data obtained from this clinical trial demonstrate the potential advantages of using acupuncture for postoperative pain control after total knee arthroplasty.
–Acupuncture for Pain Relief After Total Knee Arthroplasty: A Randomized Controlled Trial. Regional Anesthesia and Pain Medicine.

If you or someone you know is preparing for or recently underwent surgery – we’d love to help – Give us a call or book an appointment online!  What questions do you have about pre or post-op acupuncture?

Biological Implausibility Aside, Acupuncture Works – via The Atlantic

I get it – I absolutely get it when people are skeptical of acupuncture.  It seems a little bit crazy and out there.  Really, I do understand – my background is in neuroscience, I read scientific studies, I’ve even done a few, and I get it – you want to understand. I want to understand, too!  I **wish** I could list off all the physiological mechanisms at play, but I can’t – we don’t know them yet.  And I know this means that you may be less inclined to try acupuncture, and that’s fair. However, just because we don’t YET understand how it works doesn’t mean it doesn’t.  In my experience both as a patient and a practitioner – it works.  It works for a lot of people (not everyone, nothing does).   While I don’t need the studies to convince me of that, it’s certainly nice when some show up to illuminate a biological mechanism (did you see the Rutgers study on inflammation – so cool! ), or a study like the one below from Memorial Sloan-Kettering Cancer Center, published in the Archives of Internal Medicine that looked at the results from 29 different studies and found that acupuncture is more effective than controls for several conditions. Let’s leave sham acupuncture and placebo for a later discussion – I have lots to say about it – but for now – I’ll leave you with this quote from The Atlantic article, and urge you to read the whole thing!

“A meta-analysis of 18,000 patientablets from 29 randomized controlled studies, it found that the treatment was more effective than controls in relieving back and neck pain, osteoarthritis, chronic headache, and shoulder pain. Significantly, it also found that real acupuncture was more effective than shams.

Putting their results into context, the authors of the study explain that for a pain rating of 60 on a 100-point scale, follow-up scores decreased to around 43 for those had received no treatment, 35 for those who had received fake treatment, and 30 for those who received acupuncture. This translates into a 50 percent reduction in pain for the acupuncture patients, and only 30 and 42.5 percent reductions for the control and placebo groups, respectively.”
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Full study here: http://archinte.jamanetwork.com/article.aspx?articleid=1357513#Abstract

Also, if you are someone who finds acupuncture effective but struggles when talking about it to skeptics – take a look at this wonderful article by Mel Hopper Koppelman : HOW TO WIN AN ARGUMENT WITH AN ACUPUNCTURE HATER.  I love her take on common objections to acupuncture and her well-referenced post!  Thanks, Mel!

Acupuncture holds promise for treating inflammatory disease, study shows — via ScienceDaily


Researchers at Rutgers Biomedical and Health Sciences have found a potential new way to treat sepsis using electro-acupuncture.  Sepsis is a serious inflammatory reaction to an infection and is one of the leading causes of death in hospital settings.  Looking far a way to reduce this inflammatory response the researchers set out to work with the vagus nerve since it is involved in managing inflammation.

vagus nerve“The researchers already knew that stimulation of one of the body’s major nerves, the vagus nerve, triggers processes in the body that reduce inflammation, so they set out to see whether a form of acupuncture that sends a small electric current through that and other nerves could reduce inflammation and organ injury in septic mice. Ulloa explains that increasing the current magnifies the effect of needle placement, and notes that electrification is already FDA-approved for treating pain in human patients.” – via Acupuncture holds promise for treating inflammatory disease, study shows — ScienceDaily.

In the animal study researchers used electroacupuncture (EA) to stimulate the sciatic nerve (as a way to create a vagal response) in mice with sepsis.  What they found was a release of cytokines (these molecules limit inflammation) and dopamine  production in the adrenal medulla.  About half the mice receiving acupuncture survived for at least a week where there were no survivors in the the group that did not receive acupuncture.
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While this is an exciting development – acupuncture alone is unlikely to help most people with sepsis as it appears to be dependent on  adrenal function, which in most patients with sepsis is drastically reduced. However, uncovering these physiological mechanisms that occur with acupuncture are important in the treatment of other inflammatory conditions.

“On the one hand, he says, this research shows physical evidence of acupuncture’s value beyond any that has been demonstrated before. His results show potential benefits, he adds, not just for sepsis, but treating other inflammatory diseases such as rheumatoid arthritis, osteoarthritis and Crohn’s disease.” -via Acupuncture holds promise for treating inflammatory disease, study shows — ScienceDaily.

 

abstract here:  http://www.nature.com/nm/journal/v20/n3/full/nm.3479.html